PROPOSAL FOR THE HEALTH FUTURES HUB · 2 Proposal for the Health Futures Hub Monash University and Peninsula Health invite the Federal Government to be a partner in this proposal,

PROPOSAL FOR THE HEALTH FUTURES HUB

CONTENTS

Executive Summary 1

1. Context 3

1.1 Frankston and the Mornington Peninsula 4

1.2 The Frankston Health and Education Precinct 5

2. The Health Futures Hub 7

2.1 The Health Data and Implementation Platform 10

2.2 The Ageing and Rehabilitation Theme 14

2.3 The Addiction and Mental Health Theme 17

2.4 Activation of the Health Futures Hub 19

2.5 Advanced Infrastructure for the Health Futures Lab 21

3. Investment Summary and Expected Outcomes 23

3.1 Funding Required 23

3.2 Expected Outcomes 24

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The growing partnership of Monash University, Peninsula Health and other Frankston Health and Education Precinct partners is delivering new economic activity and positive impact in the region.

Peninsula Health and Monash University propose a new initiative to accelerate implementation of evidence-based health care – the Monash-Peninsula Health Futures Hub. The Hub will have the dual mission of transforming health service provision through implementation of evidence-based care, and expanding the horizons of health service provision.

Bringing together the major health training, education and research activities at Monash’s Peninsula campus and Peninsula Health’s Frankston Hospital, the Hub will generate new jobs and economic outcomes in the region.

Frankston and the Mornington Peninsula provides a unique setting for the Hub, enabling testing of novel models of care and interventions to improve health outcomes in the most complex and challenging conditions.

The region’s population is one of the fastest ageing in Australia and has disease rates significantly higher than the Victorian average for six of the nine National Health Priority Areas - Cancer; Mental Health; Dementia; Cardiovascular disease; Diabetes; and Injury.

The Hub will make better use of existing data and infrastructure and scale-up clinical research and implementation through further investment in infrastructure to accelerate health and medical research and strengthen our health services and systems.

A new Health Data and Implementation Platform will provide underpinning capabilities in population data linkage and specialist system change expertise to drive problem identification and research translation impact.

The Hub will initially focus on clinical themes of major relevance to Frankston and the Mornington Peninsula communities – Addiction and Mental Health, and Ageing and Rehabilitation – which align specialist research centres, health services, community health stakeholders and consumers.

A series of individual initiatives are required to establish the Health Futures Hub, with a total budget of $138 million. These initiatives include:

Phase 1: �� New Health Data Platform at Frankston Hospital - $3 million

�� New thematic research centres in (i) Addiction, (ii) Rehabilitation, Ageing and Independent Living and (iii) Mental Health - $12 million baseline funding committed

Phase 2: �� Expansion to the Health Data and Implementation Platform at Frankston Hospital - $6 million

�� Expanded Academic Centre at Frankston Hospital to house the Platform - $17 million with $15 million already committed

�� Research programs which integrate theme activities with the Health Data and Implementation Platform to activate the Health Futures Hub - $10 million

Phase 3: �� State-of-the-art health professions education and research facility – the Health Futures

Transformation Facility – at Monash University - $90 million

EXECUTIVE SUMMARY

2 Proposal for the Health Futures Hub

Monash University and Peninsula Health invite the Federal Government to be a partner in this proposal, requesting a contribution up to $111 million.

This is matched by $23 million in total partner contribution across these individual initiatives. The partners also seek to attract a minimum of $4 million in philanthropic support to complete the investment requirements.

Investment in the Health Futures Hub will provide new infrastructure and capability in the Frankston Health and Education Precinct and will directly deliver economic benefits to Frankston and the Mornington Peninsula. This impact will be amplified in the short to medium term when theme activities attract new Government, industry and philanthropic funding.

Most importantly, the Hub will deliver a series of improvements in health service delivery to reduce the burden of complex conditions in the local Frankston and Mornington Peninsula community, and on the Australian health system. Together, we will ensure that patients with complex conditions receive the best and most appropriate health care.

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1. CONTEXT

Australia is facing an unprecedented period of change in health service delivery, ageing, and disability support. Key contributory factors are the ageing Australian demographic driving increased demand for health and aged care services and the increasing need for people living with disease and disability to function independently. The complex interactions between ageing and the burden of chronic conditions such as mental health disorders and physical disability are increasingly evident, further complicating our approach to system transformation.

The challenge for health and aged care services is to deliver sustainable, evidence-based, efficient models of care, capable of serving people with increasingly complex conditions while at the same time improving the number of years that people live independently and in good health.

Complicated health care funding models across multiple jurisdictions, silos of data collection systems and poor cross-sector communication make it difficult to monitor and improve the management of the complex and growing group of patients with chronic conditions. These factors also make it difficult to understand the cost benefits of healthcare investments and policies from a societal perspective.

In addition to the broad health service challenges, there are immediate issues to address:

�� Harms related to alcohol, drugs and gambling cost the Australian community over $35 billion dollars annually, with significant impacts on individuals, families and the community.

�� Hospital separations for psychotic disorders due to methamphetamine use tripled between 2008 and 2013.

�� The 2007 National Survey of Mental Health and Wellbeing indicated that one in five people aged between 16 and 85 experience one of the common forms of mental illness in any one year.

These challenges need to be approached with the recognition that many different clinical and community groups must collaborate to deliver sustainable, evidence-based models of care.


1.1 Frankston and the Mornington Peninsula

Frankston and the Mornington Peninsula has a unique population demographic and health service provider setting which makes it an ideal environment for testing novel models of care and interventions which may improve health outcomes in our challenging areas of ageing, addiction, mental health and chronic disease.

The region:

�� Has 17.3% of its population over the age of 70, nearly double the proportion in Greater Melbourne (9.7%), while Frankston City has added over 3,500 older workers, pre-retirees, empty-nesters and retirees (50-69 years) in the 5 year period between 2011 and 2016;

�� Has rates of disease that are significantly higher than the state average for six of the nine National Health Priority Areas. These diseases are: Cancer; Mental Health; Dementia; Cardiovascular disease; Diabetes; Injury – and has one of the fastest ageing populations in Australia, further amplifying the burden of age-related chronic illness;

�� Covers a well-defined geographic area serviced primarily by a single public health service and is not located near any other state borders (important for state held data linkages);

�� Contains a broad range of residents from different socio-economic strata, servicing both metropolitan and regional areas;

�� Has an established history of using digital medical records for health service evaluation;

�� Already applies a unique medical record number to patients across all of the Peninsula Health systems (acute, sub-acute, community care). This is not the case with most other health services.

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1.2 The Frankston Health and Education Precinct

The Frankston Health and Education Precinct is a vibrant, integrated health, business and education precinct in and around Frankston, and centred on Peninsula Health’s Frankston Hospital and Monash University’s Peninsula campus.

The Precinct’s key strengths are aligned with key priority sectors for Australia’s economy which provides significant potential to create high-value jobs and improve community access to health and education services. Forecast growth in the Precinct will bring new opportunities for employment, education, innovation, and leading-edge research, and this will underpin future economic development and job creation in Victoria and Australia.

Peninsula Health is the public healthcare provider for the metropolitan and regional areas on Victoria’s Mornington Peninsula. With over 900 beds they provide a wide range of services from obstetrics to aged care, rehabilitation, emergency and intensive care, oncology, psychiatric services and Hospital in the Home (HITH).

Peninsula Health has delivered $150 million in capital investment over five years to support growing healthcare demands. At Frankston Hospital specifically, this includes an $81 million development opened in 2015, with a new Emergency Department, a Coronary Care Unit and two general wards; a new $5 million hybrid interventional theatre and a major $3.8 million upgrade to mental health facilities.


Strategic service planning has revealed that increasing demand due to ageing and chronic disease will particularly affect the communities in Frankston and the Mornington Peninsula. Innovative models of care involving integrated community approaches and better use of technology may relieve some pressure, but there is no doubt that Frankston Hospital will require significant growth in inpatient beds.

Monash University is Australia’s largest and most innovative university, ranked among the top 100 universities in the world. Its Peninsula campus has a growing critical mass of academic staff and research expertise with a focus on working with partner organisations in the Frankston and Mornington Peninsula region.

As one of the region’s largest employers, Monash directly employs over 250 staff and contributes to over 1,000 jobs across the region and the rest of Victoria. In 2018, nearly 4,000 students are studying at Monash Peninsula, bringing thousands of visitors to Frankston and the Mornington Peninsula, with an estimated contribution of around $27 million to the economy.

The Monash University Peninsula Campus Plan: Beyond 2016 outlined a bold vision for a vibrant, integrated health and education precinct. The University is making considerable inroads towards its vision, making prominent appointments and facilitating innovative projects. Monash University is actively supporting the current proposal for the Baxter train line electrification to further activate the Precinct.

Monash Partners Academic Health Science Centre is an NHMRC accredited Advanced Health Research and Translation Centre with the purpose of connecting clinicians and community to innovate for better health. By facilitating collaboration across health services, Monash Partners has achieved impactful outcomes in improving care and resource utilisation such as through the Monash Partners Falls Alliance. Monash Partners connects the Monash-Peninsula Health Futures Hub to the national network of Advanced Health and Research Translation Centres to facilitate national translation.

The purpose of this proposal is to seek support from the Australian Government to establish the transformational Monash-Peninsula Health Futures Hub, which brings together key partners in the Frankston Health and Education Precinct with the shared focus on improved health outcomes through improved service delivery at the local, state and national levels.

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2. THE HEALTH FUTURES HUB

AIM 1 AIM 2

Addiction and Mental Health

Ageing and Rehabilitation

Figure 1: Major clinical themes of the Health Futures Hub in which the goal is to achieve service transformation through (i) evidence-based care and (ii) expanding the horizon of health service delivery.

Actual service model

delivered

Current evidence-

based service model

New horizon service model

Improving effectiveness

and efficiency of service delivery

The significant physical presence and commitment of two health and education organisations in Peninsula Health and Monash University, combined with the regional attributes and economic growth requirements, creates a new opportunity to focus activity and investment in Frankston on redesigning the future of community-focused healthcare.

We propose to establish the Health Futures Hub, creating a test-bed for health service development, research and evaluation integrated in the Frankston and Mornington Peninsula community. The Hub will be linked at the State and National level through the Monash Partners Academic Health Science Centre, the national network of Advanced Health and Research Translation Centres and national networks of excellence.

Vision: To conduct translational research and equip the workforce to transform current approaches to health, care and support service provision to meet the future needs of Australian society.

The Health Futures Hub, will be focused on two mechanisms of health service transformation, described below, and focused within clinical themes of (i) The Ageing and Rehabilitation Theme and (ii) The Addiction and Mental Health Theme, as shown in Figure 1

1) Service transformation through evidence-based care

Aspects of health service delivery are hamstrung by the inherited burden of service models employed by previous generations. These models, thought best at the time, are now inconsistent with the current evidence base. Failures to translate research into practice is found across many areas of health service provision and improving this situation will deliver rapid improvements in outcomes.


2) Expanding the horizons of health service delivery

We recognise that the Australian community is not static, nor is the technological or environmental context in which it exists. What were once optimal models of care at the start of the 21st century will not be the same as those that meet the needs of Australian society by 2050. There is a constant need for health services to push the barriers of the current evidence base so that it can better meet the Australian health, care and support needs on our horizon.

The Health Futures Hub will be implemented in three phases.

The most significant enabler of the Hub will be the new Health Data and Implementation Platform. The Platform will provide research infrastructure and interdisciplinary expertise in Bioinformatics, Large Data Manipulation and Linkage, Engineering, Clinical Medicine, Health Services Research, Biostatistics, and Implementation. This unique, multidisciplinary critical mass of expertise in Frankston and the Mornington Peninsula will be shared across all research needs. The Platform will identify issues and challenges in health service delivery, assist in design and testing of newly developed technology and interventions.

Figure 2: Phase 1 of the proposal establishes the Health Data and Implementation Platform and research themes. Phase 2 activates the Health Futures Hub by growing scale and integrating Platform capabilities with research themes. Phase 3 realises the complete Health Futures Hub in the new Health Futures Transformation Facility, rapidly scaling implementation and impact.

Phase 1 Establishment the Platform

and Research Themes

Phase 2Activation of the

Health Futures Hub

Phase 3Advanced Infrastructure

and Realisation

2019

2021

2024

REALISATION OF HEALTH FUTURES HUB

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The Hub’s Themes will work closely with two already funded Research Centres – the Monash Addiction Research Centre (MARC), and the Rehabilitation, Ageing and Independent Living (RAIL) Research Centre for community-wide approaches to these issues. A new Mental Health Research Centre (MHRC) is to be established.

Thematic activities will engage varied stakeholder groups, such as health service delivery partners (including community and aged-care), patients and community advocates. In some cases these Centres will join forces to challenge complex interactions between theme topics. The interactions of groups within the Hub are depicted in Figure 3.

Figure 3: Themes will coordinate activities through the Health Futures Hub and specialist Research Centres, leveraging the Health Data and Implementation Platform and Health Futures Transformation Facility to transform health services in partnership with relevant local delivery partners and patient and advocacy groups in living labs.

Emerging and Future Themes

Ageing and Rehabilitation

Addiction and Mental Health

Health Data and Implementation

Platform

Health Futures Transformation

Facility

MHRC RAIL

MARC

Living Labs

LO

CA

LS

TA

TE

NA

TIO

NA

LN

TE

RN

AT

ION

AL

IMP

LE

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NTA

TIO

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Delivery partners

Patient advocates

Researchers

Clinical and research students

Monash-Peninsula Health Futures Hub

Test beds

Health Data Platform

Stimulation Environments


2.1 Health Data and Implementation Platform

The Challenge

There are numerous reasons why current evidence-based models of care are not being implemented in Australia. Some relate to the capacity, opportunity and motivation of key decision makers within these service organisations to access and use this evidence base to drive change. Improving this capability can deliver real and direct impact.

We also understand that decision making, particularly in chronic disease management, depends on the ability to successfully and continually map health utilisation and monitor outcomes. An example of success in this regard is the Rochester Epidemiology Project associated with the Mayo Clinic in the United States where medical records from multiple healthcare sources have been linked for all people living within a defined geographic region to improve healthcare delivery. These systems are a rich resource for a large number of clinical trials and several population-based studies of incidence, prevalence, long-term outcomes, health services utilisation and cost-effectiveness. The infrastructure and expertise to establish such a system is not available currently at Peninsula.

Our Response

The Health Data and Implementation Platform will provide unique skills across a range of clinical research, epidemiology, implementation science, and biostatistics to support service transformation. We will use the Platform’s specialist expertise to support decision makers. The Platform will use a common set of change theories and follow a consistent program logic that seeks to employ:

1. Stakeholder-driven identification of evidence-practice gaps.

2. Collaborative review of evidence in area by academics and practitioners.

3. Engaging policy makers, service providers, and consumers to form evidence-based recommendations to guide service delivery in this area.

4. Identification of key barriers for the implementation of the evidence-based recommendation.

5. Testing the effectiveness and efficiency of different dissemination methods to mitigate barriers and enable the translation of evidence-based recommendations into service delivery.

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In response to the need for real evidence, we will establish an Australian first dynamic digital data platform to track chronic disease management. A whole of population approach will be adopted by creating a “spine” based on Medicare usage to enumerate our cohort, 91% of the population already make a claim through Medicare each year (feasibility of this approach has already been discussed with the AIHW data linkage unit).

The Platform will be established in two stages. In the first stage, the core analytical data set of the Health Data Platform will be established within Peninsula Health. This will require support for both data infrastructure, and management and operations. In the second stage, we will link multiple cross-sector data sources, with data regularly obtained to allow dynamic mapping over time of outcomes and health service utilisation. Such a digital platform will lend itself to the most efficient way to test the impact of interventions across sectors within the health system over years. Sentinel projects will leverage newly recruited multi-disciplinary and implementation-focussed expertise within the Health Data and Implementation Platform and the two clinically focussed themes.

The Platform will provide:

�� Unique infrastructure for easy and efficient testing of innovative models of healthcare and policy initiatives such as the My Health Record (opt out proposal);

�� Easy, reliable and ongoing monitoring of health service performance through the inclusion of health service performance indicators;

�� Linkages with project specific data, such as clinical trials, for robust evaluation of outcome;

�� Data integration with data systems such as primary care, ambulance, registries; industry or privately held data (e.g. MePACS) for healthcare evaluation;

�� Integration of new and rapidly advancing digital technologies.

The aim, beyond the 5 year establishment period, is for the Platform become integrated into the Monash University Technology Research Platforms which aim for sustainable business models.


Academic Centre at Frankston Hospital

Peninsula Health and Monash University are in planning to develop an Academic Centre in the heart of the Frankston Hospital site. This facility is proposed to open early 2020 and to host clinical research and education facilities:

�� Shared education and training facilities

�� Academic Staff accommodation

�� Library and research administration accommodation

�� Clinical research consultation rooms

If the Hub proposal is successful, this facility will be expanded to host the Health Data and Implementation Platform, which will maximise access and foster collaboration for research and clinical staff.

The activities and expected costs associated with establishment and scale-up to the Health Data and Implementation Platform are shown in Table 1. The total investment required, specifically relating to establishing the core infrastructure and expertise of the Health Futures Hub is estimated at $11 million over the period 2019-2023.

Architectural render of the planned $17 million Academic Centre at Frankston Hospital

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Table 1: Activities and investment required to establish the Health Data and Implementation Platform.

Platform activities Description Estimated cost

Establishing the Health Data Platform

Establish a core analytical dataset within Peninsula Health and partners.

Infrastructure needs:

• Cerner EMR researchmodules

• High performancecomputing capacity

• Data storage

Key expertise in:

• Informatics, Bioethics, DataLinkage and Management

Data Research Infrastructure and Expertise:

• $3 million over 2 years (2019-2020)

Scale-up to the Health Data and Implementation Platform

Fully establish the integrated data system with cross-sector linkages between multiple sources of health data.

Infrastructure needs:

• Remote health serviceinfrastructure

• High-end interventionalmonitoring

• Cerner EMR researchmodules (recurring costs)

Key expertise in:

• Informatics, Bioethics, DataLinkage and Management

• Clinical Research

• Biostatistics

• Implementation Science

• Health Economics

Expand the Frankston Academic Centre to house the Health Data and Implementation Platform

Data Infrastructure and Expertise:

• $6 million over 3 years(2021-2023)

New infrastructure to accommodate staff:

• $2 million in 2021 (afurther $15 million alreadycommitted by the Hubpartners)


2.2 The Ageing and Rehabilitation Theme

The Challenge

Ageing, frailty and chronic complex diseases commonly cause loss of function and participation, leading to institutionalisation. This is often followed by rapid deterioration of a person’s medical condition and impact on end of life care.

Australian health care delivery for some of the frailest members of our community is limited on several fronts:

1) Hospital services are inadequately designed to deal with frequent readmissions of frail elderly people with complex chronic disease.

2) The aged care sector has minimal capacity to manage a rapidly deteriorating patient.

3) Linkage and access to primary health care services is poor.

Consequently, older people are less able to live independently in the community and may be frequently transported to hospital, leading to frequent hospital readmissions.

Aged care facilities frequently send patients requiring what is essentially end of life care to hospital emergency departments, which is directly at odds with the stated preference of many Australians to live in their own homes during the final years of life and until the very end. Many patients are unable to advocate for themselves at this point in their life.

We have recent legislative changes in Victoria which enable individuals to plan for their own end of life care in a manner that cannot be overridden by family members. This puts the onus on health and care staff to follow these plans or risk deregistration. These changes will have minimal impact unless people explicitly make plans regarding their end of life care that can be enforced through this legislative framework.

We are now in a phase of technological development that will enable continued independence at home for older people. It is becoming possible to design, monitor and enhance living environments, and improve physical function using remote guidance. This largely untapped field presents a substantial opportunity to create new models of health care and rehabilitation for older people that address the above stated limitations, and reduce dependence on hospitals alone to provide their care.

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Our Response

The Ageing and Rehabilitation Theme will take multiple approaches to meet these challenges, leveraging Platform capability.

RAIL (Rehabilitation, Ageing and Independent Living) Research Centre will be established as a partnership between researchers and local health networks to realise integrated rehabilitation for aged care, disability and injury. RAIL’s approach is to leverage interdisciplinary expertise from Monash University, Peninsula Health and partners in ageing health and the physiological, behavioural and environmental risk factors for disease, positioning the Hub to achieve research outcomes highly relevant and swiftly translatable to practice.

Through the work in the Hub, RAIL efforts will directly focus on the Frankston and Mornington Peninsula region.

Priority areas will be:

End of life care: We will co-develop strategies and programs with members of the community to engage and assist those at risk of having an unwanted transfer to the emergency department, to develop their end of life care plans.

As these programs are rolled out across the Peninsula, the impact on unwanted or unnecessary emergency department presentations will be evaluated using data-driven approaches, and will serve as an example for other jurisdictions across Victoria and the nation. This research will engage our experts in ageing, bioethics, health service management redesign, health economics and the data linkage capability.

Technology and Rehabilitation: We will design new models of care using assistive technology within purpose built facilities, testing their efficacy, implementing successful results in the community by integrating with community services and primary care, and continually evaluating outcomes of implementation using digital data, data linkage, and large data analytics.

This will improve continued successful living at home, reduced use of precious hospital beds and stretched clinics, and ultimately greater quality of life. We seek to improve the efficiency of currently complex rehabilitation systems which tend to be hospital centric, in order to improve recovery and participation.

In addition, RAIL will focus on how we can enable consistent planning of advanced care for residents of aged care facilities and develop better systems and technologies of remote monitoring to improve outreach aged care support.


Funding is committed to establish RAIL in Phase 1, with funding of the Director and their staff by Monash University - $4 million (2018-2023).

RAIL targets Australian Medical Research and Innovation priorities in Data and Infrastructure, Health Services and Systems in discovery of affordable models of healthcare and evidence-based approaches to prevention of ageing and injury related disease and management of living with disease and end-of-life care, as well as in Capacity and Collaboration. All RAIL successes will be co-facilitated by advocacy, consumer, clinical, implementation and research partners.

RAIL is ideally positioned to leverage project specific funding from Australian and International competitive grants, tenders and other sources in partnership with public and private healthcare implementation agencies such as Peninsula Community Clinics, the Government Home Care Packages program, residential care providers, health insurers and the National Disability Insurance Agency.

2.3 The Addiction and Mental Health Theme

The Challenge

Over the last 15 years strong research evidence has been developed demonstrating a major effect on outcomes in both addiction and severe psychiatric illnesses of rigorously applied psychological and psychosocial interventions.

It is also apparent from health services evaluation and research that public mental health and alcohol and drug services do not deliver those known and effective therapies to their patients and families in routine practice. This contributes to ongoing high demand for detoxification and alcohol and drug rehabilitation services, acute psychiatric care, family breakdown, chronic disability, co morbidity, high relapse rates, and high hospitalisation and readmission rates.

We recognise that routine implementation of evidence supported treatments in health services often lags well behind the evidence base and this problem particularly affects the addiction and mental health fields.

In the addiction field: There is typically a 10-year delay from developing a problem to seeking help, largely due to stigma, meaning that when people access treatment they present with multiple morbidities and poorer outcomes, with service models inconsistent with the available evidence, and treatment drop-out common.

In the mental health field: It has been estimated that the likelihood of a person with schizophrenia receiving any evidence-based treatment whilst attending a public mental health service is around 20%. This figure appears similar across jurisdictions and international boundaries.

Our Response

The Addiction and Mental Health Theme will focus on developing packages of deliverable, contemporaneous and effective treatment for both addiction and severe mental illness that are adapted for Australian public alcohol and drug, and mental health services.

The theme includes Peninsula Health’s Mental Health service, recognised as a strong leader in the provision of best practice alcohol and drug and mental health care, the new Monash Addiction Research Centre (MARC), which includes the Turning Point - Australia’s leading addiction treatment, education and research centre providing evidence-based solutions and the forthcoming Mental Health Research Centre (MHRC).

MARC’s approach is to leverage cutting edge epidemiology, neuroscience, innovative workforce and policy development, as well as novel treatment paradigms. Through the work in the Hub, MARC efforts will directly focus on the Frankston and Mornington Peninsula region.

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MARC and the MHRC will utilise the program logic described above, with a particular focus on clinical competencies and resources needed for clinicians and carers in the public health system to routinely provide the current evidence-based therapies to consumers.

We will partner with organisations working in the Greater Frankston Region to identify solutions at the local level that can be scaled and adapted to address similar problems more broadly. This builds on capability of Peninsula Health and Monash University, and relationships with the local Primary Health care system including Headspace and the South-East Melbourne Primary Health Network.

Through this approach, the Hub will build a scalable national response that will address workforce competency and service and system design, as well as developing innovative telehealth responses to engage patients and their families sooner, and recovery models that hasten reintegration into the workforce and community.

Funding is committed for Phase 1 and will be sought by the Hub partners to establish MARC and MHRC:

�� MARC establishment – funding of Director and their staff by Monash University - $4 million (2018-2023)

�� MHRC establishment – plans to seek philanthropic funding for establishment from key philanthropists with a strong interest in Frankston and the Mornington Peninsula - $4 million (2018-2023).

The clinical themes will leverage existing relationships across a range of industry stakeholders including state and federal governments, health insurers and aged care providers to attract industry or government funding, e.g., Emergency Departments, Ambulance Victoria, Turning Point and the Primary Health care system including Headspace and the South-East Melbourne Primary Health Network.

The Hubs’ collaborative efforts align with Australian Medical Research and Innovation priorities for Data and Infrastructure, Capacity and Collaboration, Health Services and Systems, targeted translation and the forthcoming Medical Research Future Fund Million Minds mission.

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2.4 Activation of the Health Futures Hub

The final phase of activation of the Health Futures Hub is the integration of the Health Data and Implementation Platform with theme activities.

Integration of activities across the Platform and the themes within the Hub will underpin applied research and rapid translation of research evidence into practice to improve service delivery.

Sentinel data and change management programs for the Addiction and Mental Health Theme will map trajectories of escalating alcohol, drug and mental health problems so as to inform the design of models of prevention and early intervention.

The Hub will allow a comprehensive map of how clinical issues within the theme currently intersect with the health system, and quantify the impact on outcomes of pre-hospital and hospital care (e.g. length of stay, complications etc.). Through data-linkage and mapping of service utilisation, we will identify ‘touchpoints’ that can be used to deliver prevention and early intervention initiatives, and enable the service system to be reoriented to meet patients where they intersect with the health care system.

Sentinel data and change management programs for the Ageing and Rehabilitation Theme will evaluate interventions and implementation success of existing programs and future initiatives.

Management and prevention of age- and injury-related conditions requires a comprehensive and dynamic understanding of health needs, health utilisation, and response to interventions among people affected. The Platform provides the essential digital data platform to map health care utilisation and evaluate outcomes in this context and the implementation expertise to rapidly translate findings into practice and will be expanded to include novel test beds and stimulation environments bridging research and practice and linking acute and community-care.

Across the themes, Health Futures Hub activities will include:

�� Development of continuous improvement cycles across specialties, mirroring best practice examples in Europe and North America

�� Development of internal benchmarks of clinical success that can be applied across the health service to guide improvement in care delivery and service efficiency.

As the Health Futures Hub is scaled up, so will its impact, with plans for:

�� Initiation of informatics collaboration within Monash Partners, capitalising on existing research and clinical relationships

�� Collaboration between hospitals that share Cerner over 3-5 years – data standardisation efforts will guide the sharing of best practices within the themes across Monash Partners, leading to improved care delivery in South-East Melbourne and aiding health service sustainability.


The activities and expected costs associated with activation of the research themes within the Health Futures Hub are show in Table 2. The total investment required, specifically relating to establishing the theme-specific expertise and activities of the Health Futures Hub is estimated at $10 million over the period 2021-2023.

Table 2: Activities and investment required to integrate theme activities with the Health Data and Implementation Platform

Activities Description Estimated cost

Integration of Health Data and Implementation Platform activities with research themes

Accelerate research and translation with theme activities in sentinel data and change management programs.

Sentinel data and change management programs aligned to research themes:

Ageing and Rehabilitation Theme


Addiction and Mental Health Theme


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2.5 Advanced Infrastructure for the Health Futures Hub

Advanced infrastructure is required to fully support the activities of the Health Futures Hub. This includes simulation environments to test new technologies for in-home care and aged-care facilities, outpatient clinics to evaluate newly developed models of care and training and education facilities to build the future community-based health workforce.

We propose, as part of the realisation of the Health Futures Hub, to construct a new building at the border of the Monash Peninsula campus and Frankston Hospital, providing state-of-the-art facilities for both research and education focusing on community based health care.

The Health Futures Transformation Facility at Monash Peninsula campus will include translational clinics and advanced simulation environments to provide a test bed for developing and evaluating new models of care, with a particular focus on technology supported in-home and community based care.

Research facilities will be designed based on international best practice models and aligned to the clinical themes.

Next generation teaching spaces, in line with the University’s Better Teaching Better Learning agenda, will be designed specifically for health professional courses. Bringing together research and education will allow proven research outcomes to be directly incorporated into training programs accelerating translation benefits. Students trained in this facility will become the future health workforce, creating positive impact through continuous improvement.

Living Laboratories (Living Labs) – collaborative research and translation teams including research experts, clinicians, consumer representatives and end-user partners – will be created to ensure research is conducted with respect to real life use cases to maximise adoption of outcomes by users.

Table 3: Infrastructure projects required to establish the Health Futures Hub

Infrastructure Projects Description of facilities provided

Health Futures Transformation Facility

Estimated cost: $90 million

• Translational outpatient clinics, including telemedicine

• Multi-reality simulation environment for research and training

• Advanced assisted living simulation environments

• Next generation learning and teaching facilities

• Platform staff accommodation

• Research Centre accommodation

The total investment required for this capital project is $90 million.


Design Principles for the Health Futures Transformation Facility

The Health Futures Transformation Facility will house translational clinics, advanced simulation environments, next generation teaching spaces and collaborative research spaces.

Advanced simulation enviroments

Enabling data-driven research Active learning spaces

Spaces for connection and integration of researchers, clinicians, community partners and consumer representatives

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3. INVESTMENT SUMMARY AND EXPECTED OUTCOMES

A series of investments are needed to achieve the full potential of the Health Futures Hub.

Peninsula Health and Monash University have a shared commitment to improving health outcomes and health service efficiency in Frankston and the Mornington Peninsula through evidence-based service delivery and delivering the Hub as outlined in this proposal. As such they continue to make strategic investments in the Frankston Health and Education Precinct.

A number of recent investments made by the project partners support the outcomes of the Hub:

�� $30 million in new student accommodation for 150 new students at Peninsula campus;

�� $2.1 million to translocate the School of Allied and Primary Health Care to the Monash Peninsula with recruitment of a new Head of the School to lead the expansion of research and enterprising activity

�� $3.8 million in new Psychiatric Assessment and Planning Unit and refurbishment of the psychiatric inpatient unit.

3.1 Funding Required

As part of the $138 million Health Futures Hub proposal the partners commit the following, which is a total commitment of $23 million.

�� $15 million contributions to the Frankston Academic Centre

�� $8 million committed to two new research centres – RAIL and MARC

�� Commitment to seek $4 million philanthropic funding to support establishment of MHRC

The level of investment sought for this major initiative is $111 million, which will support specific initiatives as follows:

Phase 1:�� $3 million foundational funding to establish the Health Data Platform (2019-2020)

Phase 2:�� $6 million to fund activation of the Health Data and Implementation Platform with the

required data infrastructure and expertise (2021-2023)

�� $10 million to fund sentinel data and change management frameworks aligned to the two research themes (2021-2023)

�� $2 million co-contribution to the Frankston Academic Centre

Phase 3:�� $90 million contribution to the Health Futures Transformation Facility.


3.2 Expected Outcomes

The first 3 years of the Health Futures Hub will improve health service research capability and start to deliver improved outcomes in health service delivery.

Creation of the Health Data and Implementation Platform will:

�� Enable the dynamic use of large scale, multi-organisation electronic health data, while maintaining data integrity and privacy

�� Provide new human and technological capacity in health data science that underpins activity and success in our proposed clinical themes

�� Create a national test-site for detailed mapping of health utilisation for individuals, their health needs, and health service demand

�� Improve workforce capability in data-driven decision making and organisational change.

The development of the sentinel data and change management frameworks within the major research themes in Addiction and Mental Health, and Ageing and Rehabilitation will result in major health benefits to the public, while creating significant efficiencies in the health system through workforce and research outcomes.

Theme activities will:

�� Increase provision of innovative, technology assisted models of out-of-hospital health care and rehabilitation services in older people with complex chronic disease

�– Increase duration of independent living for people with complex disease

�– ~50% reduction in transfers from aged care facilities to emergency units

�– Reduce per capita demand for aged care facility beds

�� Increase rates of evidence-based care delivery in alcohol and drug and mental health public services

�– Reduce recurrent admissions to hospital for people with mental health disorders and addiction, particularly in those with complex chronic conditions

Realising the full potential of the Health Futures Hub through the Health Futures Transformation Facility will be transformational for the Frankston Health and Education Precinct, not only for health service delivery and innovation, but also for a range of economic and workforce benefits. The Hub will:

�� Deliver innovative technologies to support independent living and new service models through development and commercialisation activities

�� Attract investment from private industry towards health transformation in the spheres of technology, bioinformatics and data management.

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Economic benefits include:

�� More than 150 jobs related to ongoing research and also construction activities

�� Attracting a greater component of the Australian competitive research funding pool to the Frankston Health and Education Precinct, specifically from the Medical Research Future Fund

�� Industry and industry-funded activities attracted to the Precinct, resulting in job growth

�� Improved health workforce outcomes resulting in productivity gains

�� High quality students and trainees attracted to Monash University and Peninsula Health, resulting in increased economic benefits.

Documents

PROPOSAL FOR THE HEALTH FUTURES HUB · 2 Proposal for the Health Futures Hub Monash University and Peninsula Health invite the Federal Government to be a partner in this proposal,